Quality Improvement Meeting 7/9/2009 Recap

What is this all about?

1. We've got to figure out better ways to collaborate in our residency because we really can't all meet up at the same time and place with any regularity
2. Here we can exchange information and we won't gum up our Mayo email boxes.

What is Quality Improvement?

1. Looking at how we do things. Objectively analyzing it. Making changes for the better.
2. Examples abound at Mayo: Sentinel events, root cause analyses, human factors, simulation
3. One approach: PDSA
   1. Plan
   2. Do
   3. Study Results
   4. Act
   5. {repeat just like shampoo}
4. Quality Improvement will be a fact of life once we're out of residency

The short history of Quality Improvement

1. Process improvement fairly successful during World War II (we won).
2. Pioneered by W. Edwards Deming
3. After WWII, Gen. McArthur (in charge of post-war Japan) brings W. Edwards Deming to Japan to help rebuild
4. The Japanese idea of Kaizen: improvement for good
5. Fast-forward and now they’re building the Prius and we’ve got … General Motors.

In medicine currently we are increasingly being held responsible for results

1. Reexamining the way we address medical processes because cost controls are coming
2. Some core measures [for Minnesota Community Measures Project]
   1. Diabetes Care
      HgA1c <>
   2. Vascular Disease (CAD)
      LDL <>
   3. Depression
      PHQ-9 <>
   4. Preventive Services
      mammo, PAP, lipids, immunizations, etc.